B51.0 vs D73.5
B51.0 and D73.5 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on D73.5
rupture of spleen due to Plasmodium vivax malaria (B51.0)
B51.0
Plasmodium vivax malaria with rupture of spleen
Billable
- Chapter 1
- Certain infectious and parasitic diseases
- Section
- B50-B64
Indexed under
- Rupture, ruptured › spleen › due to P. vivax malaria
- Malaria, malarial › vivax › with › ruptured spleen (fever)
D73.5
Infarction of spleen
Billable
- Chapter 3
- Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
- Section
- D70-D77
Use when the record says
- Splenic rupture, nontraumatic
- Torsion of spleen
Indexed under
- Hematoma › spleen (traumatic) (skin surface intact)
- Hemorrhage, hemorrhagic › spleen (concealed)
- Infarct, infarction › spleen
- Necrosis, necrotic › spleen (ischemic)
- Thrombosis, thrombotic › spleen, splenic (bland) (multiple) (progressive) (silent) (vessel)
These two codes sit in different chapters of the Tabular List, which is usually the clearest signal that they describe different underlying processes rather than different degrees of the same one.
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027